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Opinion

Commentary: Our unbalanced system for health insurance

The Miami Herald

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April 03, 2009 10:58 AM

This editorial appeared in The Miami Herald.

Among the many issues on America's healthcare–reform agenda, one deserving a high priority should be to level the playing field for people looking to buy health insurance.

As it now stands, insurers have most of the advantages. Example: rejecting potential customers because of "preexisting conditions." Congress and President Barack Obama should put a stop to this practice. Meanwhile, Florida Insurance Commissioner Kevin McCarty should ask the Legislature for reforms.

In a Page One story last Sunday, Miami Herald reporter John Dorschner described how some insurers use secretive underwriting guidelines to blacklist people with certain ailments or who take certain drugs. For example, one insurer's guideline recommends rejecting people who have diabetes, multiple sclerosis, schizophrenia, Parkinson's Disease, Hepatitis C or AIDS/HIV. Other guidelines suggest automatic denial of people who take the anti-clotting drug Plavix or Seroquel, of those who use prescribed anti–psychotic medications, and anyone who uses certain medications for sleep apnea.

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Insurers should not be expected to automatically enroll anyone who applies for a policy. They must be able to determine the amount of risk they are taking on in order to price policies appropriately and to earn a profit. Insurers also need to be able to protect themselves from people who lie about ailments in order to get coverage. At the same time, though, honest consumers should get a fair shake, which means not having to demonstrate a level of pristine health that virtually no one can attain. Without the right rules in place, insurers would cover only healthy people and have no risk at all.

Insurers say that their underwriting rules are based on standards set by the industry and by the state and federal governments. This is where change should begin. President Obama has said he wants to make insurance much more affordable and that having nearly 50 million Americans without health coverage is unacceptable. He stops short, however, of embracing universal healthcare.

To read the complete editorial, visit The Miami Herald.

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